Splenic metastases-not a frequent problem, but an underestimate location of metastases: epidemiology and course
Splenic metastases-not a frequent problem, but an underestimate location of metastases: epidemiology and course
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DOI：
10.1007/s00432-008-0502-3
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发表时间：
2009-05-01
影响因子：
3.6
通讯作者：
Dommisch, Klaus
中科院分区：
文献类型：
--
作者：
Sauer, Joerg;Sobolewski, Karin;Dommisch, Klaus
目的在文献中，脾转移的发生率的记载非常不一致。只有卵巢癌的转移才建议进行手术治疗。我们检查了脾转移的频率在我院。方法Tumorboard Schwerin的数据进行了分析脾转移。结果29,364例恶性肿瘤患者中有6,137例发生转移，转移率为20.9%。我们发现这些患者中有59例脾转移（0.96%;所有恶性肿瘤患者的0.002%）。男子比妇女更经常受到关注。患者的中位年龄为62（26-88）岁。只有少数原发性肿瘤转移到脾脏中超过1%。共47%的转移是同步的，53%是异时的。仅3例患者有孤立性脾转移。另外两名患者也有脾门淋巴结转移。另外两名患者在脾切除术后发生肝转移。因为脾脏转移，我们做了四次脾切除术。脾转移的生存中位数为3（0-61）months.Discussion脾转移的频率发表的研究是尸检研究，这是不适用于流行病学的声明，因为选择偏差。我们发现脾转移发生在不到1%的所有转移。如果转移瘤是孤立的，脾转移瘤的脾切除术是有意义的。这也是有意义的，作为一个减瘤程序，将随后进行化疗，如。G.在卵巢癌的情况下。因此，接受脾切除术的患者的生存期增加（中位生存期19.5个月对3个月）。
Objective In the literature the frequency of splenic metastasis is documented very inconsistently. Only metastases of ovarial cancer are recommended for a surgical therapy. We examined the frequency of splenic metastasis in our hospital.Method The data of the Tumorboard Schwerin has been analyzed for splenic metastases. Based on hospital documents and contact via telephone the clinical course of the patients was also examined.Results A total of 6,137 of 29,364 patients with malignant tumors developed metastases (20.9%). We found 59 of these patients with splenic metastases (0.96%; 0.002% of all patients with malignant tumors). Men were more frequently concerned then women. The median age of the patients was 62 (26-88) years. There are only a few primary tumors metastasized in more than 1% into the spleen. A total of 47% of these metastases were synchronous, 53% metachronous. Only three patients had isolated splenic metastasis. Two further patients also had lymph node metastasis in the splenic hilus. Two other patients developed liver metastases after splenectomy. We performed four splenectomies because of splenic metastasis. The survival of splenic metastasis was median 3 (0-61) months.Discussion The published studies of the frequency of the splenic metastasis are autopsy studies, which are not usable for epidemiological statements because of selection bias. We show that splenic metastases arise in less than 1% of all metastases. A splenectomy in case of splenic metastases makes sense, if the metastases are isolated. It is also meaningful as a debulking procedure that would be followed by a chemotherapy, e. g. in case of an ovarial carcinoma. As a result the survival is increased for patients undergoing splenectomy (median survival 19.5 vs. 3 months).